The Roybal Center for Health Policy Sinnulation develops better models to understand the consequences of biomedical developments and social forces for health, health spending, and health care delivery. It builds on a large body of research at RAND, including a multi-year effort to identify and forecast the consequences of health status trends and medical breakthroughs over the next 30 years. Center pilots have led to more than $10 million in additional funding, numerous scientific articles directed to the health policy community, and wide dissemination of the models and findings via the internet and briefings to policymakers and researchers. The ultimate goal of the Center is to translate this existing work - as well as other, aging-related research at RAND - into policy tools that result in better health investments. The proposed renewal will support a Management Core and Pilot Core to predict the consequences of new technologies and treatments for health care spending (both public and private), health status, and longevity. Each pilot project will meet one of four objectives: (1) Research the basic determinants of costs and health status among the elderly and near elderly; (2) Develop simulation models to predict costs, health, functional status, and longevity; (3) Apply these models to assess the value of interventions or treatments; and (4) Disseminate the tools to decision makers in industry and the government. The proposed renewal would focus initially on four areas. First, we will model the consequences of Alzheimer's disease and dementia for society, and to identify the consequences of the most promising potential interventions. Second, we will build additional modules to understand the consequences for less prevalent but important diseases, starting with chronic kidney disease. Third, we will partner with the VA to pilot a simulation tool to prevent falls among the elderly. Fourth, we will modify our existing model to incorporate Medicare Part D.